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An 18-item standardized Asthma Quality of Life Questionnaire-AQLQ(S)

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Abstract

The purpose of the present study was to examine the validity and reliability of the Asthma Quality of Life Questionnaire-AQLQ(S) in a sample of 160 Greek patients with asthma. Following evidence for sample-specific validity, the AQLQ(S) model was examined through exploratory and confirmatory factor analysis. An 18-item AQLQ(S) with the four factors of symptoms, activity limitations, sleep, and exposure in environmental stimuli fits the data (χ2/df ratio = 2.26, NNFI = 0.92, CFI = 0.94, SRMR = 0.05). The 18-item AQLQ(S) showed a high internal consistency (Cronbach’ a coefficient ranged from 0.83 to 0.96) and high 9-week test-retest reliability (overall r = 0.88, ICC = 0.94). Responsiveness was confirmed throughout 2X2 ANOVA and 2X2 MANOVA, with respect to the total score (F = 42.30, P < 0.05), and the four AQLQ(S) factors (Wilks’ λ = 0.68, F = 17.59, P < 0.05). The cross-sectional correlations between the 18-item AQLQ(S) and the: (1) FEV1% predicted and (2) Borg scale were low and moderately high, respectively. In conclusion, the 18-item AQLQ(S) derived from exploratory and confirmatory factor analysis appeared to have sufficient construct validity, cross-sectional validity, responsiveness, satisfactory test-retest reliability and internal consistency evidence for the Greek sample of adults with asthma.

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References

  1. Schipper, H., Clinch, J., & Powell, V. (1996). Definitions and conceptual issues. In B. Spilker (Ed.), Quality of life and pharmacoeconomics in clinical trials (pp. 11–23). Philadelphia: Lippincott-Raven.

    Google Scholar 

  2. Juniper, E. F., Guyatt, G. H., Streiner, D. L., & King, D. R. (1997). Clinical impact versus factor analysis for quality of life questionnaire construction. Journal of Clinical Epidemiology, 50, 233–238.

    Article  PubMed  CAS  Google Scholar 

  3. Ehrs, P. O., Sundblad, B. M., & Larsson, K. (2006). Quality of life and inflammatory markers in mild asthma. Chest, 129, 624–631.

    Article  PubMed  CAS  Google Scholar 

  4. Juniper, E. F., Guyatt, G. H., Epstein, R. S., Ferrie, P. J., Jaeschke, R., & Hiller, T. K. (1992). Evaluation of impairment of health related quality of life in asthma: Development of a questionnaire for use in clinical trials. Thorax, 47, 76–83.

    Article  PubMed  CAS  Google Scholar 

  5. Juniper, E. F., Buist, S., Cox, F. M., Ferrie, P. J., & King, D. R. (1999). Validation of standardized version of the asthma quality of life questionnaire. Chest, 115, 1265–1270.

    Article  PubMed  CAS  Google Scholar 

  6. Leroyer, C., Lebrun, T., Proust, A., Lenne, X., Lucaw, E., & Rio, G. (1998). Knowledge, self-management and quality of life in asthma: A cross-sectional study of the French version of the asthma quality of life questionnaire. Quality of Life Research, 7, 267–272.

    Article  PubMed  CAS  Google Scholar 

  7. Sanjuas, C., Alonso, J., Ferrer, M., Curull, V., Broquetas, J. M., & Antò, J. M. (2001). Adaptation of the asthma quality of life questionnaire to a second language preserves its critical properties: The Spanish version. Journal of Clinical Epidemiology, 54, 182–189.

    Article  PubMed  CAS  Google Scholar 

  8. Spirić, V. T., Bogić, S. M., Janković, S., Maksimović, N., Miljanović, S. M., Popadić, Α. P., Rasković, S., & Milić, N. (2004). Assessment of the asthma quality of life questionnaire (AQLQ): Serbian translation. Croatian Medical Journal, 45, 188–194.

    Google Scholar 

  9. Tan, W. C., Tan, J. L., Wee, E. L., Niti, M., & Ng, T. P. (2004). Validation of the English version of the asthma quality of life questionnaire in a multi-ethnic Asian population. Quality of Life Research, 13, 551–556.

    Article  PubMed  Google Scholar 

  10. Oguzturk, O., Ekici, A., Kara, M., Ekici, M., Arslan, M., Iteginli, A., Kara, T., & Kurtipek, E. (2005). Psychological status and quality of life in elderly patients with asthma. Psychosomatics, 46, 41–46.

    Article  PubMed  Google Scholar 

  11. Apter, A. J., Reisine, S. T., Affleck, G., Barrows, E., & ZuWallack, R. L. (1999). The influence of demographic and socioeconomic factors on health- related quality of life in asthma. Journal of Allergy and Clinical Immunology, 103, 72–78.

    Article  PubMed  CAS  Google Scholar 

  12. Grammatopoulou, E., Skordilis, E., & Koutsouki, D. (2007). Validity and Reliability of the Standardized Asthma Quality of Life Questionnaire—AQLQ(S) in Greece. In M. A. Lange (Ed.), Leading edge psychological tests and testing research (pp. 89–108). New York: Nova Science Publishers.

    Google Scholar 

  13. Rowe, B. H., & Oxman, A. D. (1993). Performance of an asthma quality of life questionnaire in an outpatient setting. American Review of Respiratory Disorders, 148, 675–681.

    CAS  Google Scholar 

  14. Rutten-van Mölken, M. H., Custers, F., van Doorslaer, E. A., Jansen, C. M., Heurmann, L., & Maesen, F. V. (1995). Comparison of performance of four instruments in evaluating the effects of salmeterol on asthma quality of life. European Respiratory Journal, 8, 888–898.

    PubMed  Google Scholar 

  15. Juniper, E. F., Guyatt, G. H., Ferrie, P. J., & Griffith, L. E. (1993). Measuring quality of life in asthma. American Review of Respiratory Disorders, 147, 832–838.

    CAS  Google Scholar 

  16. Leidy, Ν. Κ., Chan, K. S., & Coughlin, C. (1997). Psychometric performance of the asthma quality of life questionnaire in a US sample. Quality of Life Research, 7, 127–134.

    Article  Google Scholar 

  17. Juniper, E. F., Norman, G. R., Cox, F. M., & Roberts, J. N. (2001). Comparison of the standard gamble, rating scale, AQLQ and SF-36 for measuring quality of life in asthma. European Respiratory Journal, 18, 38–44.

    Article  PubMed  CAS  Google Scholar 

  18. Sherrill, C., & O’Connor, J. (1999). Guidelines for improving adapted physical activity research. Adapted Physical Activity Quarterly, 16, 1–8.

    Google Scholar 

  19. Sawilowsky, S. (2000). Psychometrics versus datametrics: Comment on Vacha-Haase’s ‘reliability generalization’ method and some EPM editorial policies. Educational and Psychological Measurement, 60, 174–195.

    Google Scholar 

  20. Thompson, B., & Vacha-Haase, T. (2000). Psychometrics is datametrics: The test is not reliable. Educational and Psychological Measurement, 60, 174–195.

    Google Scholar 

  21. Yun, J., & Ulrich, D. (2002). Estimating measurement validity: A tutorial. Adapted Physical Activity Quarterly, 19, 32–47.

    Google Scholar 

  22. Herdman, M., Fox- Rushby, J., & Badia, X. (1997). ‘Equivalence’ and the translation and adaptation of health-related quality of life questionnaires. Quality of Life Research, 6, 237–247.

    Article  PubMed  CAS  Google Scholar 

  23. Global strategy for asthma management and prevention. Global initiative for asthma (GINA) 2006. Retrieved March 8, 2007 from http://www.ginasthma.org

  24. Borg, G. V. (1982). Psychological bases of perceived exertion. Medicine and Science in Sports and Exercise, 14, 377–381.

    PubMed  CAS  Google Scholar 

  25. Pfeifer, K. A., Pivarnik, J. M., Womack, C. J., Reeves, M. J., & Malina, R. M. (2002). Reliability and validity of the Borg and OMNI rating of perceived exertion scales in adolescent girls. Medicine and Science in Sports and Exercise, 34, 2057–2061.

    Article  Google Scholar 

  26. Thomas, J., & Nelson, J. (1996). Research methods in physical activity. Champaign: Human Kinetics.

    Google Scholar 

  27. Pedhazur, E., & Pedhazur-Schmelkin, L. (1991). Measurements, design, and analysis: An integrated approach. Hillsdale: Erlbaume.

    Google Scholar 

  28. Gill, D., & Deeter, T. (1988). Development of the sport orientation questionnaire. Research Quαrterly, 59, 191–202.

    Google Scholar 

  29. Bentler, P. M. (1995). EQS structural equations program manual. Los Angeles: BMDP Statistical Software.

    Google Scholar 

  30. Hoyle, H., & Panter, T. (1995). Writing about structural equation models. In R. H. Hoyle (Ed.), Structural equation modelling: Concepts, issues and applications (pp. 158–176). Thousand Oaks: Sage.

    Google Scholar 

  31. Skordilis, E. K., Sherrill, C., Yilla, A., Koutsouki, D., & Stavrou, N. A. (2002). Use of the sport orientation questionnaire with wheelchair athletes: examination of evidence of validity. Perceptual and Motor Skills, 95, 197–207.

    PubMed  CAS  Google Scholar 

  32. Bentler, P. M., & Bonett, G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88, 588–606.

    Google Scholar 

  33. Byrne, M. A. (1989). A primer of LISREL: Basic applications and programming for confirmatory factor analytic models. New York: Springer-Verlag.

    Google Scholar 

  34. Tabachnick, B. G., & Fidell, L. S. (1998). Using multivariate statistics. New York: Harper Collins.

    Google Scholar 

  35. Jöreskog, K., & Sorbom, D. (1993). LISREL 8: Structural modeling with the SIMPLIS command language. Hillsdale: Erlbaum.

    Google Scholar 

  36. Steinger, J. H. (1990). Structural model evaluation and modification: An interval estimation approach. Multivariate Behavioural Research, 25, 173–180.

    Article  Google Scholar 

  37. Hu, I., & Bentler, P. M. (1999). Cut-off criteria for the fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modelling, 6, 1–55.

    Article  Google Scholar 

  38. Hair, J. F., Anderson, R. E., Tatham, R. L., & Black, W. C. (1998). Multivariate data analysis. Upper Saddle River: Prentice-Hall International.

    Google Scholar 

  39. Mardia, V. (1970). Measures of multivariate skewness and kurtosis with applications. Biometrics, 57, 519–530.

    Article  Google Scholar 

  40. Safrit, M. J. (1990). Introduction to measurement in physical education and exercise science. Boston: Times Mirror/Mosby: College Publishing.

  41. Stevens, J. (1996). Applied multivariate statistics for the social sciences. New Jersey: Lawce Erlbaum Associates.

    Google Scholar 

  42. Bentler, P. M., & Chou, C. P. (1987). Practical issues in structural modelling. Sociological Methods and Research, 16, 78–117.

    Article  Google Scholar 

  43. Juniper, E. F., Guyatt, G. H., Cox, F. M., Ferrie, P. J., & King, D. R. (1999). Development and validation of the mini asthma quality of life questionnaire. European Respiratory Journal, 14, 32–38.

    Article  PubMed  CAS  Google Scholar 

  44. Juniper, E. F., Wisniewski, M. E., Cox, F. M., Emmett, A. H., Nielsen, K. E., & O’Byrne, P. M. (2004). Relationship between quality of life and clinical status in asthma: A factor analysis. European Respiratory Journal, 23, 287–291.

    Article  PubMed  CAS  Google Scholar 

  45. Juniper, E. F., O’Byrne, P. M., Ferrie, P. J., King, D. R., & Roberts, J. N. (2000). Measuring asthma control, clinic questionnaire or daily diary? American Journal of Respiratory Critical Care Medicine, 162, 1330–1334.

    CAS  Google Scholar 

  46. Babiniotis G. (2002). Dictionary of the New Greek language. Athens: E.P.E. Center L.

    Google Scholar 

  47. Guillemin, F., Bombardier, C., & Beaton, D. (1993). Cross-cultural adaptation of health-related quality of life measures: Literature review and proposed guidelines. Journal of Clinical Epidemiology, 46, 1417–1432.

    Article  PubMed  CAS  Google Scholar 

  48. Juniper, E. F. (2005). Assessing asthma quality of life: Its role in clinical practice. Breathe, 1, 193–204.

    Google Scholar 

  49. Hays, R. D., & Hadorn, D. (1992). Responsiveness to change: An aspect of validity, not a separate dimension. Quality of Life Research, 1, 73–75.

    Article  PubMed  CAS  Google Scholar 

  50. Feinstein, A. R. (1983). An additional basic science for clinical medicine: IV. The development of clinimetrics. Annals of International Medicine, 99, 843–848.

    CAS  Google Scholar 

  51. Hyland, M. E. (2003). A brief guide to the selection of quality of life instrument. Health and Quality of Life Outcomes, 1, 1–5.

    Article  Google Scholar 

  52. Schmidt, S., & Bullinger, M. (2003). Current issues in cross-sectional quality of life instrument. Archives of Physical Medicine and Rehabilitation, 84, 29–34.

    Article  Google Scholar 

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Acknowledgements

The authors wish to thank the clinical staff of the asthma department of the Amalia Fleming Hospital in Athens, Greece, and the patients for their valuable contribution and participation in the present study.

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Correspondence to Eirini Grammatopoulou.

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Grammatopoulou, E., Skordilis, E., Koutsouki, D. et al. An 18-item standardized Asthma Quality of Life Questionnaire-AQLQ(S). Qual Life Res 17, 323–332 (2008). https://doi.org/10.1007/s11136-007-9297-y

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